Connect with us

Mississippi Today

Pressure grows for lawmakers to pass postpartum Medicaid extension

Published

on

Pressure grows for lawmakers to pass postpartum Medicaid extension

As the first major legislative deadline of 2023 nears, legislative leaders face growing pressure to extend health care coverage for moms on Medicaid from two months to one year.

After Speaker of the House Philip Gunn killed the effort last year, a bipartisan coalition of lawmakers, mothers across the state and health care professionals are ratcheting up the conversation at the Capitol this session about the benefits of the bill for Mississippi mothers and children. Mississippi, as it has for many years in a row, has the highest infant mortality rate and among the highest maternal mortality rates in the nation.

Several lawmakers — Republicans and Democrats in both the House and Senate — filed bills early this year to extend the Medicaid coverage to one year. This would put Mississippi on the same page as 29 other states, including most of the Southeast. Eight additional states are currently considering full extended coverage or a limited extension of coverage.

The Senate last year overwhelmingly passed the legislation and has since held hearings where experts and physicians spoke to its positive impact on women and babies’ health. Several senators filed bills early this year to extend postpartum Medicaid coverage, and Lt. Gov. Delbert Hosemann said he would usher it through his chamber.

And in the House, Rep. Missy McGee, R-Hattiesburg, filed a bill this year to extend the coverage. Several of her Republican colleagues, including Rep. Rob Roberson, R-Starkville, co-authored the bill.

“I really think that this is a pro-family position and certainly a pro-life position to take care of these moms who are carrying and delivering and bringing these babies into the world,” McGee said. “Healthy moms equal healthy babies. They go hand in hand, so I really believe it’s currently the most impactful thing we can do for women and children.”

Roberson, who authored the main postpartum bill last year that the House never had the opportunity to vote on, also cited being pro-life as a reason he fully supports the extension.

“I feel like if you’re pro-life, then this is a pro-life issue,” Robertson said. “You support the baby and the mother for as long as we can, and obviously we have financial constraints that enter into this, but I do think in the long run it would be less expensive and more conducive to the health of that child and that mother.”

But that momentum could halt, as it did last year, at the House dais, where Gunn wields immense power. He could, as he did last year, block the issue from ever coming up for a full vote.

Gunn spoke to Mississippi Today this week about his stance on the proposal. He said he believes the Mississippi Division of Medicaid should act — not the Legislature — to extend the coverage.

“My point is, any time I can call an agency and say, ‘Fix this by regulation, it doesn’t take legislation,’ that’s the best way to do it,” Gunn told Mississippi Today on Monday. “Legislation is the hardest way to get it done. If the Division of Medicaid felt like it was a good idea, they could’ve submitted a request a year ago and I believe CMS would grant it in a heartbeat.”

The Division of Medicaid has not taken a stance on extending postpartum coverage. But even a committee appointed by Republican leaders, including Gunn, to advise on Medicaid policy recommended that the Legislature extend postpartum coverage.

Dr. David Reeves, a pediatrician from the Gulf Coast whom Gunn appointed to the committee tasked by law to advise and make recommendations to the agency, penned a letter to state leaders, including Gunn, earlier this year urging them to extend postpartum Medicaid coverage to 12 months. 

“I see moms that lost postnatal care after a few months and ended up pregnant again, or have postpartum depression and couldn’t get treatment,” Reeves told Mississippi Today. “A lot of women do have complications during pregnancy, and they need follow up (care) that will take more than two months — like for gestational diabetes, hypertension … These things need continued coverage.”

Gunn said he had not seen Dr. Reeves’ letter. The Division of Medicaid, which is housed under the governor’s office, did not respond to questions Mississippi Today sent over a five-day period. Medicaid Executive Director Drew Snyder did not return text messages to his personal cell phone about the issue.

Staffers for Gov. Tate Reeves, who oversees the Division of Medicaid and appointed Snyder, also ignored questions from Mississippi Today on the topic of extending postpartum coverage.

In the Mississippi Today interview this week, Gunn said he has asked the Division of Medicaid for data on how continuous coverage during the federal public health emergency impacted health outcomes for women and babies, but he has not received it. Trey Dellinger, Gunn’s chief of staff, told Mississippi Today he wanted to see data that covers whether there was “any actual change in maternal or infant mortality.”

Experts say Gunn’s office hasn’t seen that data because it does not exist yet.

“The research awards for … what the full impact of the postpartum coverage extension has been — those were just awarded, and they’re five year grants,” said Maggie Clark, senior state health policy analyst for Georgetown University Center for Children and Families. “We’re not going to know the impact of this (extended coverage during the Public Health Emergency) nationally and definitely at the state level for many years.”

In Mississippi, for example, the latest maternal mortality data available is for the time period of 2013-2016. The Health Department has said it plans to release a report for 2017 through 2019 soon.

Clark made another point about making decisions around postpartum based solely on mortality numbers.

“The goal of extending postpartum coverage is to support maternal health. There’s a lot more to maternal health than, ‘Did you die?’” she said. “That’s just the absolute bare minimum.”

A recent Texas study, however, showed postpartum women with continuous coverage used twice as many postpartum services, up to 10 times as many preventive, contraceptive and mental health services, and 37% fewer services related to what’s called “short interval pregnancies” within the first year postpartum compared to before continuous coverage was in place.

Short interval pregnancies are defined as becoming pregnant within six months after giving birth – and they are associated with a higher risk for preterm birth. For mothers over 35 with short interval pregnancies, there’s an increased risk of death and serious illness. 

Dellinger, Gunn’s chief of staff, said they had reviewed that study but concluded it was not the data they needed to see.

“The Texas study you sent us, it showed there was increased utilization of health care services,” Dellinger said. “But what it didn’t cover was whether there was any improvement in outcomes.”

But according to Clark, the Texas study is “one of the only, if not the only” such study. She also pointed out the time frame researchers looked at was early in the pandemic (March to December 2020) — when health care utilization as a whole was down.

A reduction in short interval pregnancies, Clark said, is a positive health outcome.

The Texas study also showed an increase in the use of mental health and substance use services. Data shows mental health conditions (including substance use disorder) are the leading underlying cause in maternal mortality.

“The Texas study showing increases in services for mental health and substance use disorder is significant, because these conditions are drivers of maternal mortality,” said Clark.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

On this day in 1997

Published

on

mississippitoday.org – Jerry Mitchell – 2024-12-22 07:00:00

Dec. 22, 1997

Myrlie Evers and Reena Evers-Everette cheer the jury verdict of Feb. 5, 1994, when Byron De La Beckwith was found guilty of the 1963 murder of Mississippi NAACP leader Medgar Evers. Credit: AP/Rogelio Solis

The Mississippi Supreme Court upheld the conviction of white supremacist Byron De La Beckwith for the 1963 murder of Medgar Evers. 

In the court’s 4–2 decision, Justice Mike Mills praised efforts “to squeeze justice out of the harm caused by a furtive explosion which erupted from dark bushes on a June night in Jackson, Mississippi.” 

He wrote that Beckwith’s constitutional right to a speedy trial had not been denied. His “complicity with the Sovereignty Commission’s involvement in the prior trials contributed to the delay.” 

The decision did more than ensure that Beckwith would stay behind bars. The conviction helped clear the way for other prosecutions of unpunished killings from the Civil Rights Era.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Continue Reading

Mississippi Today

Medicaid expansion tracker approaches $1 billion loss for Mississippi

Published

on

mississippitoday.org – Bobby Harrison – 2024-12-22 06:00:00

About the time people ring in the new year next week, the digital tracker on Mississippi Today’s homepage tabulating the amount of money the state is losing by not expanding Medicaid will hit $1 billion.

The state has lost $1 billion not since the start of the quickly departing 2024 but since the beginning of the state’s fiscal year on July 1.

Some who oppose Medicaid expansion say the digital tracker is flawed.

During an October news conference, when state Auditor Shad White unveiled details of his $2 million study seeking ways to cut state government spending, he said he did not look at Medicaid expansion as a method to save money or grow state revenue.

“I think that (Mississippi Today) calculator is wrong,” White said. “… I don’t think that takes into account how many people are going to be moved off the federal health care exchange where their health care is paid for fully by the federal government and moved onto Medicaid.”

White is not the only Mississippi politician who has expressed concern that if Medicaid expansion were enacted, thousands of people would lose their insurance on the exchange and be forced to enroll in Medicaid for health care coverage.

Mississippi Today’s projections used for the tracker are based on studies conducted by the Institutions of Higher Learning University Research Center. Granted, there are a lot of variables in the study that are inexact. It is impossible to say, for example, how many people will get sick and need health care, thus increasing the cost of Medicaid expansion. But is reasonable that the projections of the University Research Center are in the ballpark of being accurate and close to other studies conducted by health care experts.

White and others are correct that Mississippi Today’s calculator does not take into account money flowing into the state for people covered on the health care exchange. But that money does not go to the state; it goes to insurance companies that, granted, use that money to reimburse Mississippians for providing health care. But at least a portion of the money goes to out-of-state insurance companies as profits.

Both Medicaid expansion and the health care exchange are part of the Affordable Care Act. Under Medicaid expansion people earning up to $20,120 annually can sign up for Medicaid and the federal government will pay the bulk of the cost. Mississippi is one of 10 states that have not opted into Medicaid expansion.

People making more than $14,580 annually can garner private insurance through the health insurance exchanges, and people below certain income levels can receive help from the federal government in paying for that coverage.

During the COVID-19 pandemic, legislation championed and signed into law by President Joe Biden significantly increased the federal subsidies provided to people receiving insurance on the exchange. Those increased subsidies led to many Mississippians — desperate for health care — turning to the exchange for help.

White, state Insurance Commissioner Mike Chaney, Gov. Tate Reeves and others have expressed concern that those people would lose their private health insurance and be forced to sign up for Medicaid if lawmakers vote to expand Medicaid.

They are correct.

But they do not mention that the enhanced benefits authored by the Biden administration are scheduled to expire in December 2025 unless they are reenacted by Congress. The incoming Donald Trump administration has given no indication it will continue the enhanced subsidies.

As a matter of fact, the Trump administration, led by billionaire Elon Musk, is looking for ways to cut federal spending.

Some have speculated that Medicaid expansion also could be on Musk’s chopping block.

That is possible. But remember congressional action is required to continue the enhanced subsidies. On the flip side, congressional action would most likely be required to end or cut Medicaid expansion.

Would the multiple U.S. senators and House members in the red states that have expanded Medicaid vote to end a program that is providing health care to thousands of their constituents?

If Congress does not continue Biden’s enhanced subsidies, the rates for Mississippians on the exchange will increase on average about $500 per year, according to a study by KFF, a national health advocacy nonprofit. If that occurs, it is likely that many of the 280,000 Mississippians on the exchange will drop their coverage.

The result will be that Mississippi’s rate of uninsured — already one of the highest in the nation – will rise further, putting additional pressure on hospitals and other providers who will be treating patients who have no ability to pay.

In the meantime, the Mississippi Today counter that tracks the amount of money Mississippi is losing by not expanding Medicaid keeps ticking up.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Continue Reading

Mississippi Today

On this day in 1911

Published

on

mississippitoday.org – Jerry Mitchell – 2024-12-21 07:00:00

Dec. 21, 1911

A colorized photograph of Josh Gibson, who was playing with the Homestead Grays Credit: Wikipedia

Josh Gibson, the Negro League’s “Home Run King,” was born in Buena Vista, Georgia. 

When the family’s farm suffered, they moved to Pittsburgh, and Gibson tried baseball at age 16. He eventually played for a semi-pro team in Pittsburgh and became known for his towering home runs. 

He was watching the Homestead Grays play on July 25, 1930, when the catcher injured his hand. Team members called for Gibson, sitting in the stands, to join them. He was such a talented catcher that base runners were more reluctant to steal. He hit the baseball so hard and so far (580 feet once at Yankee Stadium) that he became the second-highest paid player in the Negro Leagues behind Satchel Paige, with both of them entering the National Baseball Hame of Fame. 

The Hall estimated that Gibson hit nearly 800 homers in his 17-year career and had a lifetime batting average of .359. Gibson was portrayed in the 1996 TV movie, “Soul of the Game,” by Mykelti Williamson. Blair Underwood played Jackie Robinson, Delroy Lindo portrayed Satchel Paige, and Harvey Williams played “Cat” Mays, the father of the legendary Willie Mays. 

Gibson has now been honored with a statue outside the Washington Nationals’ ballpark.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Continue Reading

Trending